NYC Psychotherapist Blog

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Monday, May 24, 2010

Repeating the Same Behavior and Expecting Different Results

I was talking to a friend recently about the idea of "repeating the same behavior and expecting different results." She gave me permission to tell her story as part of my blog because she thought it might be helpful to other people. So, let's call my friend Donna (not her real name).

Repeating the Same Behavior and Expecting Different Results

Several years ago, Donna was expressing her ongoing frustration to me about her boyfriend's compulsive overspending. She and I talked about this numerous times. She usually said something like, "I told him, 'If you don't stop overspending, I'm going to stop bailing you out,' but does he listen to me? No. He just keeps overspending and I keep lending him money to pay his bills."

Donna and her boyfriend were caught in vicious cycle of his overspending and her bailing him out and then her feeling resentful about it. She knew she was caught in a cycle, but she didn't know how to get out of it. At the time, she couldn't understand why he didn't change.

One day, I came across a poem by Portia Nelson called "There's a Hole in My Sidewalk" and I thought of Donna and her habit of continually bailing out her boyfriend and continually feeling resentful about it. So, the next time that she complained to me about her boyfriend's overspending and her efforts to bail him out, I said to her, "It sounds like you have a hole in your sidewalk." She looked at me as if I was crazy, but before she could say anything else, I gave her the poem:

There's a Hole in My Sidewalk - By Portia Nelson

Chapter One:
I walk down the sidewalk.
There is a deep hole in the sidewalk.
I fall in.
I am lost...I am helpless.
It isn't my fault.
It takes forever to find my way out.

Chapter Two:
I walk down the same street.
There's a deep hole in the sidewalk.
I pretend I don't see it.
I fall in again.
I can't believe I am in the same place.
But it isn't my fault.
It still takes a long time to get out.

Chapter Three:
I walk down the same street.
There is a deep hole in the sidewalk.
I see it is there.
I still fall's a habit.
My eyes are open.
I know where I am.
It's my fault...I get out immediately.

Chapter Four:
I walk down the same street.
There is a big hole in the sidewalk.
I walk around it.

Chapter Five:
I walk down another street.

After she read the poem, Donna smiled and said, "I see what you mean. I keep falling into the same hole. I need to walk down another street."

Shortly after that, Donna found a therapist to work on this issue, and she also started attending Al-Anon to deal with the codependent dynamics between her and her boyfriend. When her boyfriend approached her the next time to tell her that, once again, he ran up his credit cards and he wanted to borrow money from her, she told him that she couldn't lend him the money. 

It was very hard for her to break her usual pattern of bailing out her boyfriend because she had been doing it for so long and he had come to expect that she would bail him out. So, of course, there was no incentive for him to change because he never had to face the consequences of his behavior. She told him that he would have to figure out some other way to deal with his debts. Needless to say, her boyfriend was very unhappy with this response and he couldn't believe that she wouldn't lend him the money.

Donna's refusal to continue in the same codependent behavior caused a big argument between them, and her boyfriend ended their relationship. 

The breakup was very hard for Donna. She went through several months of emotional pain and doubt as to whether she had done the right thing by refusing to lend her boyfriend money. Several times, she wanted to pick up the phone and tell him that she was wrong and try to reconcile their relationship. But deep down, she knew that she had done what was right for herself as well as for him.

A year later, Donna met the man who eventually became her husband. She is very happy in her relationship and, in hindsight, she realized that refusing to keep "falling down the same hole" over and over again with the same results was one of the best things that she had ever done for herself.

Making a change is a process. And changing an established pattern can be very difficult. First, you have to be aware that you're engaging in this pattern and recognize the consequences of it. It's very easy to be in denial and to blame other people or external circumstances. If and when you do become aware of an ongoing pattern that is not bringing you the results that you want, you have to be willing to change. Once you have established the willingness to change, you need to take action to stop repeating the same pattern.

Getting Help in Therapy
If you're caught in a cycle where you continue to repeat the same behavior with the expectation of different results, you could benefit from working with a licensed psychotherapist who can help you through the change process.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR, and Somatic Experiencing therapist. 

I work with individuals and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Wednesday, May 12, 2010

Becoming Aware of What We Offer in Our Interactions with Others

"Thousands of candles can be lit from a single candle, and the life of the candle will not be shortened. Happiness never decreases by being shared."

Someone shared this aphorism with me this morning. It's attributed to Buddha, even though I'm not a Buddhist, I've been thinking about its meaning throughout the day in terms of my everyday interactions with friends, family, and clients.

Living and working in NYC, in any given day, I interact with many people of diverse ethnic backgrounds, ages, races, cultures, traditions, and economic backgrounds. It seems to me that what most of us have in common is that we want to lead happy, peaceful, and meaningful lives, no matter who we are, where we come from or what our hopes and dreams are for the future. So, it's worthwhile, from time to time, to consider what we offer others in our daily interactions.

Are we mindful of the effect that we have on others?

Do we offer encouragement or discouragement?

Do we offer compassion or indifference?

In one of my prior articles, I discussed the idea of emotional saboteurs primarily from the perspective of the person who might find themselves faced with someone who, however unwittingly, might sabotage their endeavors. But it occurs to me that, if we are not mindful about it, anyone of us could be on the other end of this dynamic--being the one who might be emotionally sabotaging others. It could happen so easily without our even realizing it.

Even in our most simple daily interactions, there's often room for compassion and kindness to others, even when we might not be able to see it at first.

Mindfulness in Your Everyday Interactions with Others
I'm reminded of a brief interaction that I had several months ago with a cashier at the organic store where I usually get my dinner before I see clients in my psychotherapy private practice.
Usually, I'm in a hurry to buy the food and go back to my office for a short dinner break before my first evening client arrives. There is a particular cashier in this store who is usually cheerful and pleasant. But she looked worried, sad and distracted that day.

I was really struck by this because it seemed so unusual for her, and I usually looked forward to seeing her and exchanging pleasantries with her. But on this day, I could tell that there was something very wrong. Not wanting to intrude, I asked her how her day was going, opening up the possibility for her to talk about whatever might be going on, if she wanted to.

She seemed relieved to be able to tell someone what she was worried about, and she began to tell me about how worried she was about a medical bill that she received in error that her insurance company refused to cover. Without getting into the details of this woman's problem, after she told me about it, I realized that she was getting the runaround from the insurance company as well as the hospital. And it seemed that she was being taken advantage of because she's not from this country originally. Her bill was in the thousands of dollars and she had no idea how she would ever pay for it on her cashier's salary.

Since I'm a clinical social worker, as well as a psychotherapist, and I've helped many people with this type of problem over the years in the past, I was able to give her information about who to call and what she could do to advocate for herself. For me, it was a small gesture that took almost no time or effort on my part. But for her, it was very valuable information because she said that no one, including the social workers at the hospital, who should have been able to help her, was being helpful. Knowing that she had rights as a patient and knowing that there was something that she could do, changed her whole demeanor. She looked like her usual cheerful self again and she was very grateful.

When I went into the store the next time, she went out of her way to greet me and tell me that she was able to resolve her problem using the information that I gave her, and the hospital and the insurance company straightened out the mistake so everyone involved agreed that she was not responsible for the hospital bill. Ever since that time, she has been even more pleasant and friendly whenever I've seen her. And she was able to tell me that, once she resolved that problem, it had a positive ripple effect on her family, who had also been worried about the bill.

This is a simple example. It's not meant to brag about my good deed or to say how wonderful I think I am, but to show that any one of us , each in our own way, can have a positive effect on someone else's life without having to make very much of an effort, if we are mindful of the opportuniites when they come along. And that positive effect that we have on one person can ripple through to others.

On another day, if I had been distracted or too much in a hurry or if I had decided not to ask this woman how she was, there might have been a very different outcome for her and her family. And for me too--because afterwards I realized that it often takes so little in our interactions with others to have a positive effect.

We Can Affect Positive Change through Mindful Interactions with Others
And, most of the time, just like the candle in the aphorism at the beginning of this article, whether we are sharing our happiness, inspiration, or information, our efforts do not take anything away from us. If anything, these interactions with others allow us to see that, in a world where we often feel that we are powerless to affect change, we can often affect positive change in the lives of others, one person at a time.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist

To set up a consultation, call me at (917) 742-2624 or email me.

Monday, May 10, 2010

Ambivalence and Codependence in the Mother-Daughter Relationship

The topic of conflict and ambivalence in the mother-daughter relationship is the subject of this article. One article in a blog cannot do justice to this topic but, hopefully, it can serve as a starting point for many similar articles and it will be thought provoking (see my articles: Healing Mother-Daughter Relationships and Letting Go of Resentments in Mother-Daughter Relationships).

Ambivalence and Codependence in Mother-Daughter Relationships

The complexity of the mother-daughter relationship is derived, in part, from the fact that mothers and daughters share a biological and often certain psychological factors. 

As such, mothers often see themselves in their infant daughters, at times, projecting their own unfulfilled hopes and dreams on their infant daughters. 

In turn, daughters learn to identify with their mothers. A certain amount of maternal idealizing is a normal part of a daughter's development. 

However, when the identification or idealization interferes with a daughter's psychological development, this often interferes with the normal separation and individuation process that is necessary for the daughter to mature into her own person.

Clinical Vignette:
The following vignette which, as always, represents a composite of numerous cases illustrates how ambivalence and codependence between a mother and daughter as well as an over identification by the daughter for the mother kept the daughter stuck and unable to develop into her own person without feeling like she was betraying her mother.

When Donna began therapy, she was in her early 30s. She was already quite successful in her career. As she saw it at the time, her presenting problem was that she had a long history of problems in her romantic relationships with men. 

Her relationships always began well. However, as soon as the relationship became serious, Donna became extremely ambivalent about it and found some way to sabotage it. When she began therapy, she was in a one-year relationship with a man that she loved very much and who also loved her. She saw the potential for a good marriage with this man, but she was very frightened to make that commitment with him, and she could not understand why.

Donna's family history included her parents' divorce when she was five years old. Prior to that, she remembered a lot of arguing between her parents, who were not well suited for each other. After the divorce, the father remarried within a couple of years. However, Donna's mother sank into a depression and she began to drink heavily.

As an only child, Donna remembered feeling responsible for her mother's happiness. Her mother poured out her sorrows to Donna, and Donna did her best to try to make her mother happy by listening to her, trying to entertain her with funny stories from school, being an "A" student, and trying never to bother her mother with her own concerns. 

As a result, at a young age, Donna and her mother switched roles, and Donna became a parentified child. She learned to anticipate her mother's needs before her mother even expressed them. She even cleaned up her mother's mess when her mother got drunk and threw up around the house. For this, Donna's mother rewarded her by telling her what a wonderful daughter she was, and this made Donna feel good.

Donna's relationship with her mother continued in this way until Donna became a teenager, and she began to express a need to spend more time with her friends. Donna's mother never actually stopped Donna from going out with her friends, but when Donna got home, she often found her mother in an irritable, sullen state.

She never told Donna directly that she was unhappy that Donna was beginning to achieve a certain amount of independence that is a normal part of adolescence but, indirectly, she complained about how lonely she felt when Donna was out and how hard her life was as a single mother. 

This made Donna feel very guilty for leaving her mother alone and for going out and having a good time with her friends. At those times, Donna worked extra hard to get back into her mother's good graces. After a while, Donna's mother was appeased and, once again, she rewarded Donna by telling her that she was the best daughter that a mother could have.

At times, Donna turned down her friends' invitations to go out because she didn't want to leave her mother alone and unhappy. She also feared that her mother would drink more when Donna was out, which was often the case. At least if she was there, Donna thought, she could monitor her mother's alcohol intake and help her mother to go to bed when she was too drunk.

After her parents' divorce, Donna had virtually no contact with her father. She feared that her mother would be upset if she maintained a relationship with her father, so she ignored his phone calls and, after a while, he stopped calling.

During that time, dating boys was out of the question in Donna's mind. Her mother was very bitter about her own divorce and she would often tell Donna how awful men were. Donna was interested in a couple of boys at school, who also expressed an interest in her, but Donna felt that it would be a betrayal to her mother if she began dating boys. So, rather than dating, she stayed home with her mother and catered to her needs.

When it came time for Donna to apply for college, one of Donna's teachers, who had an intuitive sense of what was going on in Donna's home, encouraged Donna to go away to college. A part of Donna longed to be away and attend a college with an active campus life. However, a stronger part of Donna didn't want to leave her mother alone. So, she opted to go to a local college, even though other colleges offered her better opportunities and a chance for a full scholarship.

By the time Donna was a sophomore in college, she began to feel depressed and lonely. She didn't know why she was feeling this way, so she went to the student counseling center. With the help of her college counselor, Donna began to see that she was missing out on many of the social activities that other students were enjoying and that she also wanted to attend.

So, gradually, Donna became more social and, soon afterwards, she started dating, much to her mother's chagrin. By that point, Donna realized that she needed to have a social life of her own, but she continued to feel guilty and that, in some way, she was betraying her mother by spending less time with her and more time with her friends.

By the time she graduated, Donna was offered an excellent job opportunity in NYC that she knew she could not afford to pass up. With much ambivalence and guilt about leaving her mother, she moved to NYC to begin her new career. However, she called her mother several times a day to "check in" on her and to listen to her mother's problems. She also visited her mother frequently on weekends.

When Donna entered into her first serious relationship, she was wary of telling her mother. She feared that since her mother had such a low opinion of men, her mother would disapprove of her being in a relationship

When Donna finally summoned the courage to tell her mother, her mother acted as if she had not even heard her. She never expressed any curiosity about this man or even asked Donna how the relationship was going. This made Donna feel very sad and guilty--as if she was doing something wrong by having a life of her own and being in a relationship, as if she wasn't entitled to her own happiness.

Shortly after that, Donna began finding faults with her boyfriend and they started arguing. Within a few months, they were broken up. When Donna told her mother about the breakup, her mother responded by telling her to come home and spend time with her. Her mother seemed to have no recognition that Donna was heart broken.

This same pattern continued in most of Donna's relationships. She felt pulled between the man that she loved and a "loyalty" that she felt for her mother. By the time that Donna came to see me, she was miserable. She was also aware that she was ruining an otherwise wonderful relationship with a man that she really loved. But she didn't know how to stop engaging in this behavior.

We began by doing inner child work to help Donna understand and appreciate the root of her problems. Over time, she learned to have more compassion for herself when she was a child and as an adult. She also started to see how her own inner emotional conflict caused her to feel that she had to choose between her boyfriend and her mother.

With a lot of work in therapy, Donna started feeling more entitled to have a happy life and not to sacrifice her life for her mother. She also learned to see that her codependent relationship with her mother was not helping her mother or her. 

So, gradually, over time, she changed her behavior towards her mother. Rather than calling her mother several times a day, she called her once a week. Rather than spending hours on the phone listening to her mother's problems and trying to "fix" them, Donna encouraged her mother to get help.

Donna's mother did not respond well to this new change in Donna. After a few weeks of this, Donna's mother refused to talk to Donna and told her that she would talk to her when Donna "came to her senses again." 

This was a serious emotional challenge for Donna, and part of her wanted to revert back to her old behavior to "rescue" her mother. But, deep down, Donna realized that she needed to stick to what she knew was best for her and her relationship with her boyfriend. 

She also realized now that her mother would never get help for her alcoholism as long as Donna provided her with an emotional crutch. So, even though it was very difficult for her, Donna refrained from reverting back to her former dysfunctional way of relating to her mother.

After several months, Donna's relationship with her boyfriend improved substantially. Even though she missed her mother, Donna realized that she felt happier than she had ever felt and she finally felt entitled to her happiness. She also reconciled her relationship with her father.

About a year later, she received a call from her mother. Her mother told Donna that she had just completed a 28-day rehab and she wanted to reconcile her relationship with Donna. And, for the first time, she told Donna that she wanted to meet her boyfriend. This was the beginning of Donna and her mother having a healthy relationship together without much of the guilt, codependence, and ambivalence from the past.

Healthy Mother-Daughter Relationships
Even though this article focuses on ambivalence and codependence in mother-daughter relationships, I want to also say that there are many mothers and daughters who have healthy relationships. 

Healthy Mother-Daughter Relationships

Even mother-daughter relationships that begin with the sort of enmeshment, codependence and ambivalence that were involved with Donna's relationship with her mother often improve when one or, preferably both, people get psychological help.

Getting Help in Therapy
If you are part of an emotionally unhealthy mother-daughter dynamic and you want to establish a healthier relationship, you could benefit from attending psychotherapy with a licensed mental health professional who has expertise in this area.

About Me
I am a licensed psychotherapist, hypnotherapist, and EMDR therapist in New York City.

I work with individuals and couples.

To find out more about me, visit my web site: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Also, see Mother-Daughter Relationships Over the Course of a Life Time

Thursday, May 6, 2010

Do You Feel Like a Child Again During Family Visits?

What is it about family visits that make so many people regress to feeling like young children again? How is it possible that people who function very well in their every day lives--whether they're teachers, firefighters, or CEOs of major corporations--can be reduced to feeling like helpless children during a visit home to their families?

Feeling Like a Child Again During Family Visits

For many people, family visits are a time when they look forward to seeing their parents and siblings. They're fortunate to have nurturing relationships with their families, so going home is a positive experience. 

But for others, who are not as fortunate, going home to see parents is fraught with conflict and stress. Some people describe family visits as if they are tiptoeing through an area filled with land mine. They feel they must think carefully before they broach any topic that might set off either an argument or emotional estrangement.

Many people are surprised that they can feel so confident and mature in their every day life, but when they return to family's home, they feel like children again. They find themselves reacting to the same old emotional triggers that caused problems between themselves and their families when they were growing up.

A Clinical Vignette: 
The following scenario, which is a composite of many clients with all identifying information changed to protect confidentiality, is an example of the challenges that many people face when they visit their families on holidays and feel themselves regressing back to their childhood:

Roger was known in his firm as a tough and tenacious litigator. Whenever his law firm had a difficult case, the senior partners would call on Roger because he had a reputation for being one of the best attorneys in his field. He loved his work and would often spend long hours preparing for a case. He was also in a loving, stable, long-term relationship with his girlfriend, and they planned to get married.

On most days, Roger felt like he was on top of the world. He never backed away from a challenge. But all of that changed whenever he went home for a family visit, especially on Mother's Day. As he described it, he could feel himself transforming from a successful, mature adult to an angry child the moment he set foot in his parents' house. Both his mother and father overwhelmed him with unsolicited "advice" that felt like veiled criticism about everything from how to maintain his apartment to how to manage his money.

He could feel the anger rising up in him during those times because he felt infantilized by his parents. It didn't seem to matter that he was already in his early 40s, he earned a very good living, he owned several properties, he had a good relationship and good friends, and he was generally considered a very successful person by most people's standards. Notwithstanding of all this, his parents felt the need to tell him what to do, how to do it, and when to do it, and this infuriated Roger.

But what infuriated Roger the most was that he "took the bait" in these situatons every time. Even though he vowed to himself each time not to allow his parents to get him angry, he always reverted back to feeling like the angry child that he was when he lived at home with his parents. Once this dynamic was set in motion, he felt himself sliding down that same old emotional slippery slope every time.

This was Roger's presenting problem when he started psychotherapy. He wanted to be able to visit his parents (whom he really loved, despite how angry he often felt towards them) and maintain his sense of himself as a competent adult without the emotional regression. He wanted to be able to spend quality time with them without feeling emotionally triggered by their behavior when they treated him like a child.

To that end, after exploring his childhood relationship with his parents, Roger and I planned for his next visit on Mother's Day. He already knew that his mother tended not to like his Mother's Day card or any gift that he gave her. He knew that, even though his parents were well meaning, they still saw him as their youngest child who needed their "advice." He also knew that something happened to him whenever he was in their presence. He felt trapped, like a child who could not leave his parents' home and who was forced to endure behavior that humiliated and infuriated him.

Regressing to Feeling Like a Child Again During Family Visits

Before his next Mother's Day visit, Roger and I strategized about how he would maintain his sense of self as a competent, mature adult, and how he could set limits with his parents. Since these visits always made him feel anxious, we role played various scenarios which often occurred on his visits home. 

With practice, Roger felt more competent about handling the upcoming family visit. And whereas he usually did not feel entitled to set limits with his parents because he regressed emotionally to feeling like a child, with practice in our sessions, he was able to internalize that he was entitled to be treated like an adult. And if his parents had a need to treat him like a child, for whatever reason, that was their problem and he would not allow it to affect him.

On that Mother's Day, Roger visited his parents armed with the strategies that we had practiced in our sessions. He was still nervous and feared that he would sink back down into feeling like an angry, helpless child again before he would be able to implement these strategies. 
He also feared that his parents would not respond well to his setting limits with them. 

Nevertheless, he was able to stand his ground as soon as the unsolicited "advice" and veiled criticism started coming his way. At first, his parents seemed surprised. They had never experienced Roger push back before. 

But contrary to Roger's fears, he was able to set limits with his parents in a loving, tactful but firm way. It made him feel confident and empowered. And, from that day forward, his parents stopped treating him like a child, and he stopped feeling like a child in their presence.

Visiting your family on holidays like Mother's Day or Christmas can be an emotional challenge. But you can learn to change the dynamic between you and your parents during these visits. 

Often, when you change your way of relating to your parents, they will learn to respond to you as an adult and not a child. Often, the key is to learn what triggers your regression from a mature adult to feeling like a child and learn ways not to get triggered. 

That might mean setting limits on what your parents say to you, how they treat you or your partner, or it might mean spending less time with them during these visits, but making that time as enjoyable and meaningful as possible.

I knew a woman who used to hold onto her car keys in her pocket whenever she went home to visit her parents. Holding the car keys in her hand was a reminder to her that she was a mature adult who was not trapped in her parents' home like she was when she was a child. After a while, she no longer needed to do this because she internalized these feelings without the keys as "props."

Emotional regression during family visits is a common experience. Psychotherapy is often helpful to overcome these feelings. But there are no one-size-fits all strategies. Every person's experience is unique. 

Getting Help in Therapy
If visiting home brings up more intense feelings, like the type of feelings that come up that are related to childhood trauma, EMDR therapy or clinical hypnosis can be valuable in helping you to overcome trauma.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, and Somatic Experiencing therapist.

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist

To set up a consultation, call me at (917) 742-2624 or email me.